Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.
Parkinsonism Relat Disord. 2013 Dec;19(12):1094-9. doi: 10.1016/j.parkreldis.2013.07.020. Epub 2013 Aug 7.
Literature suggests that sex steroid hormones may modify the risk for Parkinson's disease (PD). We investigated the potential effect of reproductive factors on the clinical features of idiopathic PD (IPD) patients.
All IPD female patients admitted to and evaluated at our Institute over a 12-month period were included in the present cross-sectional study. We investigated the effect of the following parameters by multivariate linear regression analysis: age at menarche, age at menopause, length of fertile life, duration of exposure to endogenous estrogens and cumulative length of pregnancies, use of contraceptives and hormonal replacement therapy.
In total, 579 patients were evaluated and 497 reported menopause before PD onset. In this population, age at PD onset was positively associated with age at menarche and at menopause, length of fertile life and duration of estrogen exposure. Moreover, UPDRS motor score was inversely associated with age at menopause, length of fertile life and duration of estrogen exposure. Increasing age at menarche was also associated with predominant resting tremor at PD onset. In models refitted on patients with early PD (disease duration <5 years; N = 226) all the associations found were confirmed. The relationship between surrogates of estrogen exposure and UPDRS motor score actually became more significant.
Our observations support the concept that hormonal exposure of the nigro-striatal network during life may influence its susceptibility to degenerative stimuli in later life, but the association does not seem to be unique? unidirectional. In particular, increased severity of PD signs correlates with shorter duration of estrogen exposure. The underlying mechanisms need to be clarified.
文献表明，性激素可能会改变帕金森病（PD）的发病风险。我们研究了生殖因素对特发性 PD（IPD）患者临床特征的潜在影响。
本横断面研究纳入了在我院 12 个月内就诊和评估的所有 IPD 女性患者。我们通过多元线性回归分析调查了以下参数的影响：初潮年龄、绝经年龄、生育期长度、内源性雌激素暴露时间和妊娠累积时间、避孕药和激素替代疗法的使用。
共评估了 579 例患者，其中 497 例患者在 PD 发病前已绝经。在该人群中，PD 发病年龄与初潮年龄、绝经年龄、生育期长度和雌激素暴露时间呈正相关。此外，UPDRS 运动评分与绝经年龄、生育期长度和雌激素暴露时间呈负相关。初潮年龄增加也与 PD 发病时出现的主要静止性震颤有关。在对发病时间小于 5 年的早期 PD 患者（N=226）重新拟合模型中，所有发现的关联都得到了证实。雌激素暴露替代物与 UPDRS 运动评分之间的关系实际上变得更加显著。
我们的观察结果支持这样一种观点，即生命中黑质纹状体网络的激素暴露可能会影响其在以后的生活中对退行性刺激的易感性，但这种关联似乎不是独特的、单向的。特别是，PD 症状的严重程度与雌激素暴露时间较短有关。需要进一步阐明其潜在机制。
